Gestational Diabetes Battles!

Well it's official - I have GD. In fact when I took my 3 hour test - I didn't just fail it - I flunked the damn thing.  I failed all 4 numbers - but I wasn't surprised. I had GD last time and I'm about 10 lb and a few years older this time. We tried to go diet controlled but after a week it was very clear to me that it wasn't going to work. I was able to control my 2 hour scores but my fasting scores were constantly 20 points higher. And bless the heart of my GD counselor but when I explained that none of the tips they gave me were helping my fasting - she just kept repeating the same thing. Instead of wasting another week - I just spoke to my doc.

She put me on glyburide. Initially I was nervous but honestly - my sugars have all come down since taking it at night and there are NO SIDE EFFECTS!

It's nothing like the metformin runny tummy woes I was dealing with earlier.

Oh and here's a quick update :
1 - I'm 30.5 weeks now
2 - I have gained only 13 lb since pre-pregnancy weight
3 - I didn't gain anything in the last 4 weeks
4 - baby is measuring close to 4 lb
5 - He's also measuring a week ahead
6 - Oh and I'm roughly 5 weeks away from having my cerclage removed and graduating from my perinatologist!!

Time permitting I'll do a post about my SPD - because this has been the most debilitating thing I have ever experienced. It's worse than bed rest!!

Trending my glucose numbers with gestational diabetes

As if the excitement of sticking my fingers 4 times a day wasn't enough, I decided to actually start charting my numbers for my glucose readings. It's sort of frustrating when I see numbers that are out of range. I'm also kind of interested to see what my perinatologist and obgyn will say about these numbers. I'm sort of nervous about being prescribed glyburide. I hear about women feeling groggy and having really low blood sugars. My ketones have been awesome and are almost always in range. My 2 hour scores are pretty much manageable. The general rule is as long as it's home cooked foods, my numbers are fine. I get high numbers when I eat out. My fasting is what I can't quite figure out... It does seem to be just above normal. The only consoling thing is that our baby hasn't been showing any signs of abnormal growth because of my gestational diabetes.


Ketones
Average Ketone - 3.8 - less than trace ketones

Fasting
Average Fasting - 94.5
47% of fasting numbers in range

2 hour after Breakfast
Average 2 hours after breakfast 109
76% of 2 hour after breakfast numbers in range

2 hour after Lunch
Average 2 hours after lunch 106
88% of 2 hour after lunch numbers in range


2 hour after Dinner
Average 2 hour after dinner 115
56% of dinner fasting numbers in range

Going by these - I kind of feel like only breakfast and lunch are under control. The other numbers are a crap shoot!

Who needs gambling when I've got glucose numbers to watch

I'm roughly 6 days into testing - and I've got the swing of things. The interesting thing is that it's a crap shoot. I can mainly gauge my numbers based on what I eat, but every now and then there's a crazy one. For the first 3 days, my fasting numbers were high. For the next 3 days, my fasting numbers were good. Most of the time my 2 hour numbers are good - but then today.... my ketones were high. It's a total crap shoot. Hence my thinking - who needs to gamble when I have my random numbers to play with? I'm eager to see what my doctor ends up thinking about my numbers. I'm also curious to see what my nutritionist thinks about my numbers. All I know is that I have no intention of carrying this baby to 40 weeks anymore. Now that I know I have gestational diabetes, I think it's better if she comes out at 37 weeks before she gets too big. In fact - I plan on asking my acupuncturist to help me deliver as well. I'm also going to go on an eggplant binge and plan to walk quite a bit. But that's just some morning rambling :)

My Gestational Diabetes Class and Day 1 of Finger Pricks

My GD class wasn't that bad actually. It was roughly 3 hours of learning how to eat. It was weird at how formal they made everything, but in a nutshell, the class was straight forward. First I met with a nutritionist who went over my profile and an initial assessment quiz to see how much I understood. She looked at how I normally eat and basically set a plan for me. Since I'm on bedrest - my plan doesn't include any exercise. I never thought I'd say this - but I really do miss being able to exercise. There was a sense of freedom and strength in that. 

Anyway, I left the class armed with my new One Touch Mini glucose testing meters and a booklet to help me log my glucose levels. Before I go into that, we did do a test finger stick in the class. My score was 141. I felt bad, but then again I'd been popping grapes during the whole class. So strangely I was ravenous by the time we left that place, so I decided to stop for Vietnamese food on the way home. They have this noodle bowl dish - absolutely divine. It's a combination of rice noodles, papaya, cucumber, carrots, grilled meat, lettuce, and peanuts with a sweet hot thai chili sauce. Yumm! Needless to say... my glucose reading after that meal was off - 130 when it was supposed to be 120. Dangit! One more thing to remove from my diet! 

I had a lot of anxiety about the needle sticks. It's because of those commercials for those diabetes supplies in the mail for people on medicare. The old people in the commercials are all complaining about painful finger sticks. I was given a lancet that uses this lance called Delica. All I know is that it barely hurts at all! That was a huge relief because I was cringing at having sore fingertips. The ones that the doctor uses hurt like all hell. It feels like being stabbed in your finger!

So today was my first day of full measurements. My fasting was a bit high - 104. That threw me for a loop. My fasting has never been a problem before. I scored great with my breakfast measurement at 94. Believe it or not, they told us we could eat Chick-fil-a on our meal plans. So I tried.... and that was a fail. My lunch reading was 130. BUMMER! For dinner I had some steamed shrimp , mashed potatoes and salad. I got a wonderful reading of 104 for that - woohoo! Oh if I haven't mentioned it - anything under 120 for a meal is considered good! It hit me that this feels a bit like gambling. I play the hand I'm told to play - then we roll the dice and see what my blood sugar is. I hate the fact that I have to eat 6 times a day. It's more often and it's more food than I normally eat. I have only 6 more weeks of this or so. Then I can go back to my normal carb avoidance ways and exercising again - if I have any energy left. I'll know in a week or two if my doctor is going to put me on Glyburide. I'm hoping i can control it with just diet, but I have to admit, I feel a sense of comfort from knowing I could take a pill that would keep the levels all in check. All in all - today wasn't a bad GD day.

FMLA Drama and the beginning of my gestational diabetes journey

My FMLA mission
So I need to apply for FMLA for my maternity leave. I asked my perinatologist office if they could fill my forms out for me. I called them 2 days ago. They said that they prefer for my obgyn to do it. I then called my obgyn. They said they could do it - but I needed to bring my papers in with my next appointment - over a week from now. They also said that it would cost me $25 bucks and it would take 10 business days. If I wanted it sooner, I could pay an extra 10 bucks. ugh. Anyway, My perinatologist called me back yesterday and said - just bring your paperwork with you tomorrow. So I brought it - and get this - they filled all of it out right there and faxed it to my company HR person this afternoon. No charge!!!!

My gestational diabetes journey
So 2 weeks ago I took my 3hr test. I failed it. I thought my values were bad, but my peri didn't think so. Today I had a fresh cervix measurement. My cervix went back up to 2.1 cm wooot! The baby looks fine and my amniotic fluid levels look good. I asked my peri about my GTT scores because honestly - I think my OB's office is too lax with my care. Or maybe they think because I have a peri - they don't have to do much. Anyway - I digress. So I asked my peri about my scores. He felt they were ok - definitely gestational diabetes - but he didn't think they were that bad. They were 94 fasting, 1hr 169, 2hr 181, 3 hr 146 . 95 is the cutoff for a high fasting level - so I barely skated through on that. My 2 hour was the one that he said was really off. I have been feeling a little anxiety about the gestational diabetes thing. I'm not worried about insulin or having a big baby (because she won't make to 40 weeks anyway), but for some reason I'm really freaked out about sticking my fingers. I mean I survived the injection regiment of 2 cycles with IVF, but I just don't want to stick my fingers. The peri told me that I wouldn't have to take insulin. I could take a drug Glyburide. He said it doesn't cross the placenta. Also, I'll monitor my blood sugars and bring in my results weekly. Then if they feel like the diet isn't controlling it enough, then I'll be given the medication. He said only 15% of women with GD end up having to take a medication. So on Friday I'll go for my education, and they are going to give me my meter and strips then. Now to add insult to injury, while I was sitting with the nurses, my peri walks past the office we were in with a fistful of chocolate chip cookies. And he says, "Kat I just want to show you all the stuff you can't eat - no handfuls of cookies for you - haha!" Yes my peri has a sense of humor like that.

So here's my confession. I haven't really been eating bad at all. In fact, I don't particularly like food now that I'm pregnant. I eat because I have to but I never feel like eating. That being said, I decided to have a last fuck-the-world meal. I know that makes no sense. I've done so much to manage my diet to get pregnant and have been eating pretty well during this pregnancy, but on Friday I go back to my diabetic diet. So we went to Five Guys and I got a hot dog and a bacon cheeseburger. YUMM! It's sort of my goodbye to normal eating - that last donut before a diet. It tasted ok, but of course now I'm totally bloated and can't eat anything else. I don't think I'll be able to eat dinner in my current state. Ugh.... but tomorrow I start with all the healthy eating..

All in all I've made my peace with the gestational diabetes. Even though our baby may be born a bit big, she will be done growing most of her organs at 36 weeks, and she won't make it to 40, so she's at low risk of being a huge baby. I hope all is well with her in the long run.

I'm so heartbroken over having gestational diabetes

I didn't think I'd be upset about this - but I do feel really down about this..... I mean.. I've worked out like a mad woman for years. Hell I used to run 20 + miles a week. I lost my first pregnancy with a 20 week spontaneous dilation. UGH! I had 5 years of BFNs after that. I went through 4 months of explosive diarrhea while adjusting my body to metformin. I went through 3 months on nutrisystem to get down to an ideal weight for IVF. I went through a bout of OHSS, I spent 3 weeks where I was in excruciating pain from PIO shots - only to find out I wasn't pregnant. I went through a cerclage and my cervix still shortened! I've been on bed rest for 8 straight weeks. I have 7 more to go! Now I'm pregnant and for a moment I got excited because I've gained only 9 lb in 7 months. I thought that maybe... just maybe I'd be able to win one little battle - but NO - now I have GD too. I honestly feel mentally battered. I wake up 4 - 5 times a night. I toss endlessly. I'm just tired and sadly am secretly wishing for a break from my pregnancy. I'd love to have just 2 days where I feel normal. It's such a weight to deal with. It's like this unending monkey on my back situation that I just can't get an escape from. I find myself fantasizing about having a tiny escape from this whole fertility battle. I know I have only 6 weeks until my cerclage comes out. We're so close to meeting our baby - but wow.... I'm going to have to pull myself together to get through this. OK .... rant over

An odd encounter at a lab while getting my 3 hour glucose test

I've followed tons of forum posts and blogs with people talking about their GTT tests. People describe nausea, vomiting, horrible taste, etc. I just recently did mine and I thought I'd share my experience.

For starters, I did have some anxiety about this. The 1-hour screening test was ok. My obgyn was kind of enough to refrigerate the 50 mg drink - so it wasn't so bad. However, this time around I went to a Quest lab location for my 3 hour. They didn't refrigerate it :( so it wasn't so cool. Before I go too far down the road, here's how it went :

This is a fasting test, so I had to stop eating around 7 pm. I was convinced that I was going to be ravenous but it wasn't so bad actually. I ate my dinner at 7 and I was able to drink water afterwards. My friend picked me up around 7:15 am and we made our way out to the lab. We ended up getting there early but no biggie. After checking in once they opened, the lab tech took me in the back and drew my blood. I don't have anxiety over needles, but I was hoping she'd use a butterfly needle. That needle is always better to me. As I looked over, I saw her reaching for a butterfly needle - woohoo! She drew the blood from my right arm (injection #1). She gave me a 100 mg solution that was lukewarm to the touch. Inside, I thought .. ugh - this is going to be nasty. If you haven't tried the solution, it's like drinking a flat Fanta that's overly concentrated. It tastes like soda syrup. I was given 5 minutes to gulp it down and was told not to drink any water during the test.  The tech told me that she'd be drawing my blood every hour after that.

I went back into the lobby and sat down. Now I had company so the time went pretty quickly. I also brought my laptop and was able to find a wifi connection. I even managed to post on my forums during the test. Before I knew it - the tech was calling my name to get my blood drawn again. This time she drew blood from my left arm. For a split second, my mind drifted to thinking butterfly needle ... butterfly needle....butterfly needle.... but no such luck. She pulled out some big gauge needle and proceeded to stick my left arm :(  (injection #2) It didn't hurt so bad, but it wasn't the painless almost unnoticeable prick of the butterfly needs. She told me to go back in the waiting room and so began hour #2.

While we were sitting there, an old couple came in.  They looked like they were well into their 70's. As soon as her husband stood up to get his lab work done, she started to ask us questions about cooking. It was one of those conversations where you could tell she had something to say and that we were going to listen no matter what. She proceeded to tell us how her husband had been married before, and his old wife was still trying to get him back. She also mentioned that she had been married to her husband for 30 years... So of course I start doing the math.... He'd been married to the other woman forever a decade. He'd been married to her for over 30 years. That's 40 whole years of marriage! Wow.... you'd think after that many years, people would have settled down into accepting the fate of their relationships. I nearly giggled when the woman said, "I know why she's jealous. I don't see nice purses on her arm, but when I want a purse, my husband goes out and gets me a purse!" I honestly thought that after 30 years... jealousies get umm... more dignified. I guess not!

Not more than 10 minutes after her husband returned and they left, the tech came out and called my name.  I went in and she pulled the bandage off of my right arm. Again I thought... butterfly needle... butterfly needle... butterfly needle.... YES! She picked the butterfly needle. We made some random chatter, she told me how she lost gained only 7 pounds with her pregnancy overall. I half thought about how I was 28+ weeks and had only gained 9 pounds. Maybe I wasn't so abnormal after all. Anyway - she drew my blood (injection #3) and sent me back into the lobby. So began hour #3.

Hour 3 literally flew quickly. There was a woman who came in with her baby. Someone who looked like her mom came in and went to get something from the lab techs. There were a few other people who came in and out. Before I knew it - the tech poked her head out of the door and called my name. I walked in, and she went to take my blood (injection #4). Again - she pulled out that big needle. In my mind I'm thinking.. what the hell??  Needless to say, she drew my blood and I was all done. I walked out, headed to the lobby, grabbed my stuff, and we headed out.

Honestly this was not a negative experience. The injections weren't painful and the time flew pretty quickly.There were a few times where I felt a bit drowsy for a few minutes, but otherwise no real discomfort. Now all I have is the anxiety of waiting for the results to see if I have gestational diabetes.

Failing my glucose tolerance test - score 1 for PCOS

Well, I failed my glucose tolerance test that I took last week. I was actually kind of disappointed. The nurse tried to console me, telling me that I didn't exactly bomb it. Normal is under 140, pre-diabetic is 141-199, and diabetic is over 200. I scored 179. I didn't exactly feel good about that. I'm not entirely surprised, since I have PCOS and already have slightly elevated insulin levels.

I tell you though, I seriously thought I had a chance at beating it. This pregnancy has been so weird... I haven't been on metformin since 12 weeks. Even then my compliance wasn't that great. The thing that gave me hope was that I really haven't gained much with this pregnancy. At 24 weeks I was up maybe 6 pounds. I gained another 3 pounds or so in the next 2 weeks. That's not that bad - especially for a woman with PCOS. I've also noticed that my fat stores have actually decreased. My "tires" on my sides as my DH so fondly calls them actually shrank and disappeared. I was never really hungry and for once it seemed like my metabolism was actually working. But ugh.. alas it was short lived. 

The process for the 1-hour test isn't bad at all. I didn't have to fast or anything. I ate a light breakfast and made my way to the OB. Of course I spent too much time reading google about the test, and women talking about feeling nauseas, or hating the syrup. Fortunately the drink was given to me cold. It tastes like a cheap store-brand knock-off Fanta. I drank it in just a minute or two and then let the nurse know I was done. I waited an hour. Fortunately I also met a midwife and had a regular checkup during the appointment. So that passed the time some. Finally it was time and I got my blood drawn. That wasn't too bad but I wished the woman would have used a butterfly needle. I hate the traditional needles they like to use - they simply hurt my arms. After that.. I went home.

So now I have to wait for the doctor to send me my paperwork so I can go and do the 3-hour glucose tolerance test. It literally takes 4 hours in total... so I'm going to plan to spend my day in a lab getting my blood drawn every hour. I sincerely hope I pass this and don't get diagnosed as having gestational diabetes...